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Ductus

ExocrineGlands Target Organ

Endocrine Glands

Aliran darah

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Konsep dasar dari endokrinologiIlmu pengetahuan yang membicarakan tentang keadaan

klinik sehubungan dengan keadaan yang tidak normaldari kelenjar endokrin : satu cabang dari ilmu biologi

MASALAH MASALAH ENDOKRIN

1. Mekanisme Pengaturan

2. Efek Fisiologik

3. Patofisiologi

4. Rasional/Interpretasi

5. Cara pengobatan

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DIDALAM TUBUH

Flow of Information(Communication)

NERVOUS SYSTEM

ENDOCRINE SYSTEM

ENDOCRINE GLANDS= DUCTLESS GLANDS

secrete

HORMONES

(internal secretion)

Melalaui ALIRAN DARAH

Berikatan dengan

Plasma Protein

Free

Hormone

RECEPTOR

Reactions /

Acts

Substances other than

Hormones = LIGANDS

TARGET ORGAN

EFFECTS

Agonist ?

+

+

Antagonist ?

_

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Kerja dari Hormon

Menghasilkan energi, PemaKaian dan penyimpanan

Pertumbuhan & perkembangan

Pemeliharaan lingkunganinternal

R e p r o d u ksi

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MEKANISME MENAMBAH DAN MENGURANGI(UP AND DOWN REGULATION)

MENGURANGIKadar Hormone Serum Jumlah Receptor

MENAMBAHKadar Hormone serum Jumlah Receptor

Sensitivitas to Hormone

(Hormone Resistance)

Sensitivitas pada Hormone

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KELENJAR ENDOCRINE

Hypothalamus

Hypophysis (= Pituitary gland)

Thyroid & Parathyroid glands

and cell of Pancreatic Islets.

Adrenal gland (Cortex & Medulla)

Ovarium, Testes (Sex Organs) and Placenta

Adiposit (Fat Tissues), Cardiomyocytes (?)

Others : Juxtaglomerular apparatus (?)

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ENDOCRINE SYNDROMES

Due to Overproduction / Hypersecretion or Underp

roduction / Hyposecretion of one or some hormone

Example :

Change of Body Weight anabolic or catabo-lic abnormalities

Increased Blood Pressure kortisol, Aldoste-rone, Cortisol, Catecholamines excess.

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MEKANISME PENGATURAN

DARI SEKRESI HORMON

1.Feedback mechanism

2.Autonom mechanism

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DASAR2 PEMERIKSAAN LABORATORIUM1.- SCREENING TESTS

2.- DEFENITIVE TESTS

SPECIMENS : BIASANYA SERUM ATAU PLASMA

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H O R M O N E S

1. Polypeptides

- Anterior pituitary hormones

- insulin

- parathyroid hormone

2. Cholesterol

- cortisol

- aldosterone

- androgen (testosterone)

- estrogen (estradiol)

Amino Acid TYROSINE

3. Catecholamines

- epinephrine (adrenalin)

- norepinephrine

4. Iodothyronine

- thyroxine (T4

)

- triiodothyronine (T3)

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HYPOTHALAMUS

(releasing factors)

HYPOPHYSIS ANTERIOR

(trophic hormone)

ACTH

ADRENAL

cortisol

aldosteron

TSH

THYROID

T3

T4

FSH

LH

OVARIUM

estrogen

progesteron

FSH

ICSH

TESTIS

testosteron

_

+ +

_

+

_

+

_

-

-(Portal System)

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HYPOTHALAMUS(Paraoptic Nuclei)

POSTERIOR HYPOPHYSE

(Neurohypophyse)

(JALUR HT- HP)

A.D.H (Oxytocine)

.(Vasoppressin)

Collecting Duct dariGinjal (reabsorbsi air)

Kontraksi dariuterus

Vasoconstrition

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TIDAK ADA HUBUNGAN DENGANFEEDBACK MECHANISM

INSULINGLUCAGON

CATECHOLAMINESPARATHYROID HORMONE (P.T.H)INTESTINAL HORMONES (Secretin

GLP, etc)

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PROTEIN BOUND HORMONESSteroid Hormones

Thyroid Hormones

PROTEIN UNBOUND HORMONES

Polypeptide (eg Insulin)

Catecholamines

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RECEPTOR dan HORMONE

1. CELL MEMBRANE / SURFACE RECEPTORCorticotropine

Thyrotropine

Prolactin

Parathyroid hormone

Insulin .

2. CYTOPLASMA / NUCLEAR RECEPTOR

Cortisol

Testosterone

Estradiol

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Endocrine, metabolic disorder and nutritionEndocrinological disordersIDDM 1 2 3A3B 4NIDDM 1 2 3A 3B 4

Complication of DM (acute andchronic

) 1 2 3A3B 4Hypoglycemia 1 2 3A3B 4Diabetes incipidus 1 2 3A 3B 4

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Acromegaly, gigantism 1 2 3A 3B 4Growth hormone deficiency 1 2 3A3B 4Hyperparathyroidism 1 2 3A 3B 4Hypoparathyroidism 1 2 3A 3B 4Hyperthyroidism 1 2 3A3B 4Hypothyroidism 1 2 3A 3B 4

Thyroiditis 1 2 3A 3B 4Cushing's disease 1 2 3A 3B 4Adrenal cortex failure 1 2 3A3B 4Primary hyperaldosteroidism 1 2 3A 3B 4Phaeochromocytoma 1 2 3A 3B 4Precocious puberty 1 2 3A 3B 4Testicular feminization syndrome 1 2 3A 3B 4Hypogonadism 1 2 3A 3B 4

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Adrenogenital syndrome 1 2 3A 3B 4Addison's disease 1 2 3A 3B 4Multiple endocrinological neoplasia (mensyndrome) 1 2 3A 3B 4Tumor with ectopic production of hormone 1 2 3A 3B 4

Nutritional deficiencyMarasmus 1 2 3A 3B 4Kwashiorkor 1 2 3A 3B 4Vitamin deficiencies 1 2 3A 3B 4

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Error of metabolism

Hyperlipoproteinemia 1 2 3A 3B 4Porphyria 1 2 3A 3B 4Gout 1 2 3A3B 4Obesity 1 2 3A 3B 4

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